HomeMy Public PortalAboutUSA Pools 12/2013 STATE OF GEORGIA )
COUNTY OF CHATHAM )
AGREEMENT FOR SzRMXCaS
THIS AGREEMENT FOR services relating to the RENOVATION OF THE POOL FACILITY AT THE
RIVERS END CAMPGROUND in the City of Tybee Island, Georgia, hereinafter referred to as
"Agreement", is made and entered into as of the day of , 2013 (the
"Date Hereof"), by and between USA POOLS CONSTRUCTION, INC., whose agent and address
for purposes of this agreement is MICHELLE Payne, 885 Woodstock Road, Suite 430-132,
Roswell, GA 30075, hereinafter referred to as "the Company," and THE CITY OF TYBEE
ISLAND, a municipality, whose address for the purposes of this Agreement is 403 Butler
Avenue. P. 0. Box 2749, Tvbee Island, Georgia 31328, herein referred to as "the City."
WITNESSETH THAT:
WHEREAS, the City is a municipal corporation organized under Georgia law; and
WHEREAS, the City desires to renovate and replace all associated pool facility and structures,
including the decking, located at River's End Campground & RV Park;
WHEREAS, the Company, operating under the laws of the State of Georgia, is engaged in
providing the services required by the City;
WHEREAS, the City has solicited requests for proposals relating to the services; and
WHEREAS, the Company has submitted the attached bid; and,
WHEREAS, the Company and City desire to document the terms and conditions of their
Agreement.
NOW, THEREFORE, for and consideration of the mutual covenants contained herein, the receipt
and sufficiency of which is hereby acknowledged, it is agreed as follows:
ARTICLE 1
BASIC AGft[EEM[ENT
1.1 The Company will perform the Scope of Work ("the Work") described in RFP No. 2012-
635 City of Tvbee Island, Georgia ("RFP") ("Exhibit A"), attached hereto and
incorporated by reference as if fully set forth herein, and supply all materials in
connection therewith and will perform all preparatory and clean-up work associated
therewith.
1.2 The Company has agreed to perform the Work as described in the RFP and Quotation
Sheet ("Exhibit B") attached hereto and incorporated by reference as if fully set forth
herein. The Company and the City have agreed to an increase from the initial quotation
G:1COMMONIEMHITYBEE\0000.572.2278 I-Ty bee C ontracts-Agreements\Campground
for the installation of a different type of plaster finish than was solicited in the RFP,
Diamond Brite. The total amount the Company will be paid under this Agreement is
$42,695.00.
1.3 The Company will provide proof of liability coverage with a minimum liability amount for
comprehensive general liability and automobile liability of not less than $2,000,000.00. The
Company shall maintain worker's compensation insurance equal to the statutory requirements.
The insurance certificates shall name the City of Tybee Island as additional insured.
1.4 The Company and all of its subcontractors will comply with the necessary requirements
of all State and Federal law pertaining to the residency of its workers and will further comply
with all reporting requirements required of City contractors pursuant to the grant under which
proceeds are being made available to the City and expressly recognizes that any breach on its
part of the reporting and other requirements under such grant will result in potential liabilities
to the City and the Company will indemnify and hold harmless the City for any such damages in
addition to all other indemnity obligations contained herein or the terms and conditions
attached hereto.
ARTICLE 2
WARRANTIES
2.1 The Company shall remedy, at the Company's expense, any failure to conform,
or any defect. In addition, the Company shall remedy, at the Companys expense, any damage
to City-owned or controlled real or personal property when the damage is the result of—
(1) The Companys failure to conform to agreement requirements; or
•
(2) Any defects of equipment, material, workmanship or design furnished by the •
Company.
2.2 The Company shall restore any work damaged in fulfilling the terms and
conditions of this clause. The Company's warranty with respect to work repaired or
replaced will run for (one year unless otherwise indicated) from the date of repair or
replacement.
2.3 The Contract Administrator for the City shall notify the Company, in writing, within a
reasonable time after the discovery of any failure, defect or damage. If the Company fails
to remedy any failure, defect, or damage within a reasonable time after receipt of notice,
the City shall have the right to replace, repair or otherwise remedy the failure, defect, or
damage at the Companys expense.
2.4 With respect to all warranties, express or implied, from subcontractors,
manufacturers, or suppliers for work performed and materials furnished under this
agreement, the Company shall:
(1) Obtain all warranties that would be given in normal commercial practice;
(2) Require all warranties to be executed in writing, for the benefit of the City; and,
(3) Enforce all warranties for the benefit of the City.
G:\COMMON\EMHITYBEE\0000.572.22781-Tybee Contracts-!Agreements\Campground
2.5 Company shall not be liable for the repair of any defect of material or design furnished by
the City or for the repair of any damage(s)that result(s) from any defect in City-furnished material or
design,
2.6 Notwithstanding any provisions herein to the contrary, the establishment of the time periods
in paragraphs 3.1 and 3.3 above relate only to the specific obligation of the Company to correct the
Work, and have no relationship to the time within which its obligation to comply with the
agreement may be sought to be enforced, nor to the time within which proceedings may be
commenced to establish the Company's liability with respect to its obligation other than specifically
to correct the Work.
2.7 This warranty shall not limit the City's rights with respect to latent defects, gross mistakes or
fraud.
ARTICLE 3
COVENANTS AND REPRESENTATIONS
3.1 The Company shall perform professional services in accordance with the Company's
Proposal and Terms and Conditions contained in this agreement and contained in the RFP and
hereby expressly made a part of this agreement.
3.2 To induce the City to enter into this Agreement, the City shall be entitled to rely upon
the representations and certifications made by the Company in the Company's Proposal, without
independent investigation and verification, and each such representation or certification shall be
deemed to be material to this Agreement. The person negotiating and executing this Agreement
on behalf of the Company has the full right, power, and authority to enter into, execute and
perform this Agreement in accordance with the terms hereof, and when executed and
delivered, this Agreement will constitute a valid and binding obligation of the Company and will
be enforceable in accordance with the terms thereof.
•
ARTICLE 4 •
PAYMENT, FEES, and REBATES
4.1 The City shall pay the Company the price as provided in this agreement; Net 30.
•
•
4,2 If the City desires, the Company agrees to accept payment by purchasing credit card.
ARTICLE 5
CONTINGENCIES
•
•
5.1 The obligations of the City are subject to the following conditions:
(1) The ability of the City to carry out the terms of this Agreement in accordance with
•
the laws and Constitution of the State of Georgia.
(2) The timely performance by the Company of each and every covenant, agreement,
and obligation imposed upon the Company in this Agreement.
(3) The truth and accuracy as of the Date Hereof of each and every representation
made by the Company.
G:\COMMON\EMI I\TYBEE\0000.572.22781-'1'ybee Contracts-Agreements\Campground
(4) This Agreement is expressly made subject to other laws affecting its subject matter.
In the event of any conflict between such laws and this Agreement, such laws shall take
precedence.
5.2 The obligations of the Company are subject to the following conditions:
(1)The timely performance by the City of each and every covenant, agreement, and
obligation imposed upon the City in this Agreement.
ARTICLE 6
NOTICES
6.1 All notices, demands or requests required or permitted to be given pursuant to this
Agreement shall be in writing and given or served either in person or by United States Mail,
postpaid, registered or certified with Return Receipt Requested, showing the name of the
recipient and the date of delivery. Notices shall be addressed to the party or parties identified
and at the address as set forth in the introductory paragraph of this Agreement, and the date
upon which such notice is delivered shall be deemed the effective date thereof. Either party
may, from time to time, by five (5) days' prior written notice to the other party, specify a
different agent or address to which notices can be delivered. Rejection or other refusal to
accept a notice or inability to deliver a notice because of a changed agent or address of which
no notice was given shall constitute receipt of the notice on the date when personal service is
attempted or the date of the postmark, if mailed.
ARTICLE 7
RIGHTS CUMULATIVE
7,1 All rights, powers, and privileges conferred hereunder shall be cumulative and not
restrictive of those given by law.
ARTICLE 8
NON-WAIVER
8.1 No failure of the City to exercise any right or power given to the City under this
agreement, or to insist upon strict compliance by the Company with the provisions of this
agreement, and no custom or practice of the City or the Company at variance with the terms
and conditions of this Agreement, shall constitute a waiver of the City's right to demand exact
and strict compliance with the terms and conditions of this Agreement. •
•
•
ARTICLE 9
CONTINU]tTY
9.1 Each of the provisions of this agreement shall be binding upon and inure to the benefit
and detriment of the Company and the City and the heirs, devisees, legatees, legal
representatives, successors and assigns of the Company and the City.
G:\COMMON\EMII\TYBEE10000.572.2278I-Tybee Contracts-Agreemcnts\Campground
ARTICLE 10
CONT"•teCT MO®MF:CATIONS
10.1 (a) Only the Contract Administrator has authority to modify any term or condition of
this contract. Any contract modification shall be authorized in writing.
(b) The Contract Administrator may modify the contract unilaterally (1) pursuant to a
specific authorization stated in a contract clause (e.g., Changes); or (2) for administrative
matters which do not change the rights or responsibilities of the parties (e.g., change in the
City's address). All other contract modifications shall be in the form of supplemental agreements
signed by the Company and the Contract Administrator.
(c) When a proposed modification requires the approval of the Tybee Island City
Council prior to its issuance (e.g., a change order that exceeds the Contract Administrator's
approved threshold), such modification shall not be effective until the required approval is given
by the Tybee Island City Council.
ARTICLE 11
CHANGE ORDERS
11.1 (a) The Contract Administrator may, at any time, by written order designated or
indicated to be a change order, make changes in the work within the general scope of the
contract including changes:
(1) In the method or manner of performance of the work.
(A) Any other written order or oral order (which, as used in this paragraph (b), includes
direction, instruction, interpretation, or determination) from the Contract Administrator that
causes a change shall be treated as a change order under this clause; provided, that the
Company gives the Contract Administrator written notice stating (1) the date, circumstances
and source of the order and (2) that the Company regards the order as a change order.
(B) Except as provided in this clause, no order, statement or conduct of the Contract
Administrator shall be treated as a change under this clause or entitle the Company to an
equitable adjustment.
(C) The Company must assert its right to an adjustment under this clause within 30 days
after (1) receipt of a written change order under paragraph (a) of this clause, or (2) the
furnishing of a written notice under paragraph (b) of this clause, by submitting a written
statement describing the general nature and the amount of the proposal. If the facts justify it,
the Contract Administrator may extend the period for submission. The proposal may be included •
in the notice required under paragraph (b) above. No proposal by the Company for an equitable
•
•
adjustment shall be allowed if asserted after final payment under this contract. ;
(D) The Company's written proposal for equitable adjustment shall be submitted in the
form of a lump sum proposal supported with an itemized breakdown of all increases and
decreases in the contract in at least the following details: (1) Direct Costs. Materials (list
individual items, the quantity and unit cost of each, and the aggregate cost); Transportation
and delivery costs associated with materials; Labor breakdowns by hours or unit costs
(identified with specific work to be performed); Construction equipment exclusively necessary
for the change; Costs of preparation and/ or revision to drawings or plans resulting from the
change; Worker's Compensation and Public Liability Insurance; Employment taxes under FICA
and FUTA; and, Bond Costs when size of change warrants revision; (2) Indirect Costs. Indirect
costs may include overhead, general and administrative expenses, and fringe benefits not
G:ICOMMON\EMH\TYBFE10000.572.22781-Tybcc Contracts-Agreements\Campground
normally treated as direct costs; and (3) Profit. The amount of profit shall be negotiated and
may vary according to the nature, extent, and complexity of the work required by the change.
The Company shall not be allowed a profit on the profit received by any subcontractor.
Equitable adjustments for deleted work shall include a credit for profit and may include a credit
for indirect costs. On proposals covering both increases and decreases in the amount of the
contract, the application of indirect costs and profit shall be on the net-change in direct costs
for the Company or subcontractor performing the work.
(E) The Company shall include in the proposal its request for time extension (if any),
and shall include sufficient information and dates to demonstrate whether and to what extent
the change will delay the completion of the contract in its entirety.
(F) The Contract Administrator shall act on proposals within 30 days after their receipt,
or notify the Company of the date when such action will be taken.
(G) Failure to reach an agreement on any proposal shall not excuse the Company from
proceeding with the contract as changed.
(H) Except in an emergency endangering life or property, no change shall be made by
the Company without a prior order from the Contract Administrator.
ARTICLE 12
T7P4E OF THE ESSENCE
12.1 All time limits stated herein are of the essence of this Agreement.
AR.IICLE 13
CAPTIONS
13.1 The brief headings or titles preceding each provision hereof are for purposes of
identification and convenience only and should be completely disregarded in construing this
Agreement.
ARTICLE 14
THIRD PARTY BENEFIICIARIES/OBLIGORS
14,1 Although this agreement is a personal retention of the Company as an independent
Company, the Company and the City agree that there will be other third party obligors
subcontractors performing work on the project. The Company, however, agrees to be
responsible for ensuring that all agreement terms are complied with, regardless of the entity
performing the actual work.
ARTICLE 15
•
DRUG FREE WORK PLACE
15.1 It is the policy of the City of Tybee Island that its work place shall be a drug free
workplace in compliance with the Drug Free Work Place Act, 41 U.S.C.S. 701et.seq.
G:\COMMON\EMJ-f\rYBEE\0000.572.22781-Tybee Contracts-Agreernents\Campgrrnmd
ARTICLE 16
APPLICABLE LAWS
16.1 The Company agrees that it and all of its subcontractors will comply with ail applicable
legal requirements whether imposed by Local, State or Federal law and, further, will comply
with State "SAVE" requirements.
ARTICLE 17
JURISDICTION AND VENUE
17.1 The Company agrees that any civil action, arbitration or mediation of any dispute arising
under this Agreement shall take place only in Tybee Island or Savannah, Chatham County,
Georgia. City and Company further agree and stipulate to the jurisdiction and venue of the
United States District Court for the Southern District of Georgia, Savannah Division, the Superior
Court of Chatham County or the State Court of Chatham County over them and over any civil
action arising under this Agreement.
IN WITNESS WHEREOF, the Company and the City have caused these presents to be duly
signed, sealed and delivered on the day, month, and year first above written.
USA POOLS CONSTRUCTION,INC. CITY OF TYBEE ISLAND
Narnee .lason Bueilerman, Mayor
6�Qee Date
Date
Clerk of Co�,ncil
Date
APPROVED AS TO FORM;
Edward CM. Hushes, City Attorney
Date
G:\COMMON\EMH\TYBBB\0000.572.22781-Tybee Contracts-Agreements\Ca npground
Ifikq
RFP # 2012-635
CITY OF TYBEE ISLAND
TYBEE ISLAND, GEORGIA
IS ISSUING TIES REQUEST FOR BID FOR THE FOLLOWING DESCRIBED HEREIN:
RENOVATION OF POOL FACILITY AT RIVERS END CAMPGROUND
The City of Tybee Island is requesting proposals for Renovation and replacement of all associated
pool facility and structures,including the decking,located at River's End Campground&RV Park,5
Fort Avenue,Tybee Island,GA. Bidders shall offer services and materials which may be upgraded
with optional services and materials which may not be purchased at time of bid award. Bidder shall
specify in the proposal the delivery schedule for the products and services from time of notification
of award of bid.
BIDS ARE TO BE RETURNED NO LATER THAN: DECEMBER 21,2012 AT 10:00A.NI
BIDS WILL BE OPENED ON DECEMBER 21,2012 AT 11:00 AM AT CITY HALL.
ALL RESPONDENTS ARE INVITED TO ATTEND.
The City is seeking a total bid package for service/materials equal to or exceeding specifications
set forth on the attached pages which must meet or exceed stated specifications. Those not meeting
these standards will be rejected. The attached material specifications become and remain a part of
this request for proposal
All responses, inquiries, or correspondence relating to, or in reference to, this request for
proposals, and all reports, charts, displays, schedules, exhibits and other documentation by the
bidders shall become the property of the City when received. All proposals submitted in response
to this invitation for bid shall become the property of the City. The City retains the right to use any
or all ideas presented in any proposal to the invitation to bid,whether amended or not. Selection or
rejection of the proposal does not affect this right.
Mail proposal to: BID NUMBER 2012/635
MELISSA FREEMAN
CITY OF TYBEE ISLAND
403 BUTLER AVE
PO BOX 2749
TYBEE ISLAND, GA. 31328
EXHIBIT
Page 1 of 11
Inquiries or other need for clarification in this document should be submitted no later than
DECEMBER 19,2012.
Questions to: Woody Hemphill
912-472-5016
Cell(912)257-9890
Email: whemphill @cityoftybee.org
METHOD OF AWARD: Contracts shall be awarded to the lowest, responsive, and responsible bidder.
Bidders must respond completely by filling in all applicable blanks. Bids are subject to the terms and
conditions of this Request for Proposal.
Bids shall be submitted in a sealed envelope, clearly marked on the outside of the envelope, to the office of
the above address prior to the time specified.
Signature of bidder indicates that bidder understands and will comply with attached terms and conditions
and all other specifications made a part of this invitation for bid and any subsequent award or contract. All
terms, conditions and representations made in this invitation will become an integral part of the contract.
Nothing contained within this RFP is indicative of intent by the City of Tybee Island to reimburse
the bidder, in whole or in part, for any costs associated with preparation, submission, or
presentation of proposals.
WAIVER: The City of Tybee Island reserves the right to reject any or all bids received. The City reserves
the right to waive any variances from original bid specifications in cases where the variances are considered
to be in the best interest of the City.
SUBMESSION OF BIDS AND SUPPLEMENTAL MATERIALS
Bids and all required or requested supplemental materials in compliance with the attached specifications
shall be submitted to the above address. Supplemental materials will not be accepted after the bids have
been opened, unless requested by the City.Please include a bid sheet,W-9,vendor application, affidavit
verifying status,and contractor affidavit which can be found at the end of this request
SERVICES TO BE PROVIDED
The successful bidder shall perform the following work for the City:
Renovation and/or replacement of all associated pool facility and structure,including the
decking located at River's End Campground& RV Park,5 Fort Avenue,Tybee Islannd, GA.
Renovations to take place between the hours of 7:30AM—dark during Monday—Saturday
of the weeks between January 11,2013—March 17,2013. The renovations will be completed
in a timely manner so that it may not interfere with the normal seasonal opening of the
swimming pool. Final inspection will take place with the Campground Manager, and Ray •
Hord,Building Inspector for the City of Tybee Island. Upon completion, a pressure check
and associated evaluation will take place to assure that the pool is functioning properly by
the Campground Operations Supervisor,the City of Tybee Island on-staff CPO.
Page 2 of 11
Work to be completed will require the following:
• Drain Pool Completely(by campground staff)
• Replace all grates (VGB), skimmers,jets and valves in pool
• Apply new fiberglass coating to entire pool shell, and decorative coating (advise of options
and styles)
• Remove all existing paint/stain, and apply new matching decorative coating/with cool deck
(advise of options)to include repairing of any damaged concrete
• Remove all depth number tiles and replace with meters and feet
• Install"no diving"in tile on all four sides of pool on deck bull nose coping(top)
• Replace existing 12v light system and replace with 120v system
• Grout all tiles in need of repair and preventatively.
• Install fixed ADA lift in compliance with all current and applicable Federal ADA
Regulations.
• Re-fill pool and check for any/all leaks,and repair as needed.
• Conduct pressure test to find, diagnose, and/or remedy any leakage prior to completion
• All construction debris,and trash are to be addressed in areas outside of pool fence on
a daily basis. Trash and recycling containers are located in close proximity to the
pool, located on either side of pool fence.
• Contractor will provide solid waste rollout dumpster for any construction debris
associated with project at predetermined site, as defined by Campground staff.
NOTE: Electrical outlets are limited and located within the pool's `pump house'. Work
may entail that these outlets are unusable during the completion of the work. if not,
these outlets are available and will require coordination with Campground staff to
arrange access during work hours.
Please provide separate pricing for any associated work to be completed outside of what is
specified within this document.
PAYMENT
The bidder shall specify terms of payment. The City of Tybee Island's preferred method of payment is by
purchasing credit card.
INSURANCE REQUIREMENTS
Contractor shall provide a Certificate of Insurance naming the City of Tybee Island as also insured,
a 30 day cancellation notice, indicating the following minimum coverage:
Comprehensive General Liability $2,000,000.00
Automobile Public Liability $2,000,000.00
Page 3 of 11
Workman's Compensation Insurance equal to the statutory requirements.
TAXES
The City of Tybee Island, Georgia is not subject to any State or Federal taxes. Documentation will be
provided with the invoice at the time of payment, if requested.
DELIVERY: F.O.B.DESTINATION
403 Butler Ave,Tybee Island, Georgia 31328 unless otherwise stated.
TERMNATION OF CONTRACT
The City reserves the right to terminate the contract for reasons of violations by the successful bidder of any
term or condition of the contract by giving thirty (30) days written notice, unless otherwise stated herein,
stating the reasons therefore and giving the party ample time to remedy the deficiencies.
City of Tybee Island
TERMS AND CONDITIONS
DEFINITIONS. As used herein, the following terms shall have the meanings set forth below,
whether or not capitalized.
(a) "Purchase Order"or"Order"means this purchase order.
(b) "Buyer"means The City of Tybee Island.
(c) "Seller"or`Vendor"means the party furnishing the supplies under this order.
(d) "Supplies" means what the Seller furnishes the Buyer under this order and includes with
limitation, the following; (1) the work; materials; articles; deliverable items, items, data
and services, whether tangible or intangible or any combination thereof; and (2) what is
leased or licensed, pursuant to the lease(s) or license(s) signed by both the Buyer and the
lessor or licensor if attached to and made a part of this order.
(e) "Loss" means any or all the following: claims, liabilities, damages, losses, costs, or
expenses (including reasonable attorneys' fees and expenses and other legal costs).
ACCEPTANCE. This order constitutes an offer which shall become a binding contract upon the
terms and conditions herein set forth upon acceptance by Seller either by acknowledgement of this
order or commencement of performance. Buyer objects to any difference, conflicting or additional
terms proposed by Seller in the acceptance of this order, and no such terms shall be effective
unless expressly accepted by Buyer in writing. Each shipment received by Buyer from Seller shall
be deemed to be only upon the terms and conditions contained in this order, except by such written
instrument modifying the order, signed by Buyer, notwithstanding any terms and conditions that
may be contained in any acknowledgment, invoice, or other form issued by Seller and
notwithstanding Buyer's act of accepting or paying for any shipment, or similar act by Buyer.
PRICES. Seller represents that the prices, terms, warranties, and benefits contained in this order
are comparable to or better than those offered to any other customer of Seller for items which are
the same or substantially similar. Buyer shall receive the benefit prospectively or retrospectively if
Seller offers any item or service included in this order to any other customer at a lower price,more
Page 4ofIi
favorable terms, more favorable warranties, or more favorable benefits up to one year after
completion of this order.
PACKING AND SHIPPING. All items shall be suitable packed and prepared for shipment to
insure their safe transportation, to secure the lowest transportation cost, and to comply with the
requirements of carriers. Buyer's order number shall appear on all documents and correspondence
relating to these items. Packing lists shall accompany the items and shall include the order
number, Buyer's part number, Seller model number, description of items shipped and any other
information called for in the order. Buyer's count or weight shall be final and conclusive on
shipments not accompanied by a packing list. Seller shall be liable for all excess transportation or
other charges resulting from Seller's failure to comply with Buyer's packing, shipping,routing and
delivery instructions.
DELIVERY. Any delivery schedule made a part of this order is an important,material condition;
time is of the essence of the order. Unless otherwise agreed to in writing. Seller shall not make
material commitments or production arrangements in excess of the amount or in advance of the
time necessary to meet Buyer's delivery schedule. It is Seller's responsibility to comply with this '
schedule, but not to anticipate Buyer's requirements. In addition to any other rights or remedies,
Buyer may cancel all or any part of this order for Seller's failure to deliver in strict accordance
with the delivery terms set forth herein. Seller shall promptly notify Buyer of any anticipated
delay in the delivery date and Buyer may require Seller to ship by alternate means in order to
expedite delivery. Any additional costs shall be paid by Seller and Seller shall be liable for all
resulting damages to Buyer occasioned by the delay. Delivery shall not be deemed to be complete
until the items have been received and accepted by Buyer. Advance and excess shipments may at
Buyer's option be rejected and returned to Seller at Seller's expense.
TRANSPORTATION. Except as otherwise provided on the face of this order, transportation
charges on Supplies shall be f.o.b. destination, at Seller's sole cost and expense. Risk of loss from
any casualty to supplies ordered hereunder, regardless of cause, shall be Seller's responsibility
until goods have been delivered to Buyer's designated delivery post. No insurance or premium
transportation costs beyond the price listed in this order will be allowed unless authorized by
Buyer in writing. If Seller does not comply with Buyer's delivery schedule, Buyer may, in
addition to any other rights that Buyer may have under this order, require delivery by fastest way,
and charges resulting from the premium transportation must be fully prepaid and absorbed by
Seller.
WARRANTY. Seller warrants that all supplies delivered pursuant to this order shall strictly
conform to the applicable specifications (including without limitation information or functional
performance,material content, size, appearance, response time, etc.), shall be free from all defects
and workmanship in materials including latent defects, shall be free from defects in design and
suitable for their intended purpose, and shall be free from all claims, encumbrances, and liens.
This warranty shall survive inspection, delivery and payments shall run to Buyer, its successors,
assigns and the users of the items and shall not be deemed to be exclusive. Seller agrees to
indemnify, defend and hold Buyer, Buyer's employees, and those for whom Buyer may act as
agent, harmless from all damages, including consequential and incidental damages, incurred or
sustained by Buyer by reason of any breach of any warranty with respect to the supplies purchased_
Buyer shall be promptly reimbursed for all expenses incurred in the handling,inspection and return
of defective items, and Seller shall bear the risk of loss on all such items. If any of the supplies are
found at any time prior to acceptance to be defective in material or workmanship, or otherwise not
Page 5 of J 1
in conformity with the requirements of this order, Buyer (in addition to any other rights which it
may have under warranties or otherwise) may at its option (1) correct or have corrected the
nonconformity at Seller's expense, or(2) reject and return such supplies or other deliverable items
at Seller's expense, such supplies or other deliverable items not to be replaced without suitable
written authorization from Buyer.
CHANGES. Buyer may at any time request in writing changes to this order in the specifications,
packing, shipment, quantities, delivery schedules, and other matters. If any such change causes an
increase or decrease in the costs of or the time required for performance, Seller shall immediately
notify Buyer. Any request for an equitable adjustment must be made in writing with 30 days from
the date of the written request for the change. No additional charge or change in the specifications,
packing, shipment, quantities, delivery schedules, and other matters will be allowed unless
authorized by Buyer in writing.
TAXES. The Buyer, a municipality in the State of Georgia, is exempt from Georgia Sales Tax
under the Sales and Use Tax ID# 302 526 178. All sales and use tax due on materials purchased
by the city for installation by the seller under this contract are the responsibility of the contractor.
ASSIGNMENT. Neither this order nor any interest herein may be assigned, in whole or in part,
by Seller without the prior written consent of Buyer. Notwithstanding the above, Seller may
assign any monies due or to become due to him hereunder,provided that such assignment shall not
be binding upon Buyer until receipt of a copy of the assignment agreement is acknowledged and
approved by Buyer in writing.
SUBCON'T'RACTING. Seller shall not enter into a subcontract for any part of this order,
including completed or substantially completed items or major components thereof, with Buyer's
written consent. Nothing in this order shall be seen as prohibiting Seller's purchase of standard
commercial articles, raw materials, or other supplies specified in this order if these are typically
purchased by Seller in the normal course of business.
TERMINATION. Buyer may terminate or suspend performance under this order in whole or in
part from time to time by sending written notice to Seller. Upon receiving notice of such action by
Buyer, Seller shall immediately comply with its terms and take all reasonable steps to avoid
incurring any additional costs under this order. Buyer's sole liability to Seller shall be for items
completed and delivered to Buyer in accordance with this order and for Seller's reasonable costs to
the date of termination, such costs being solely attributable to this order and not being recoverable
from other sources.
INDEMNIFICATION. Seller agrees to indemnify, defend and hold Buyer, Buyer's employees,
and those for whom Buyer may act as agent harmless from (1) any and all claims and liabilities for
injuries or death of persons or damages to or destruction of property; (2) any other Loss caused by
or resulting from the acts or omissions of Seller, its agents, subcontractors, suppliers or employees
in the performance of this order; (3) any Loss caused by or resulting from the supplies purchased
under this order, (4) any intended use of products or materials provided by Seller; (5) any defective
products or materials provided by Seller, including without limitation the use or disposal of
hazardous and/or toxic materials, such materials to include at minimum all materials recognized by
the Environmental Protection Agency as hazardous; or (6) any breach by Seller of any express or
implied warranties. If Seller's work hereunder involves operations by Seller's agents,
subcontractors, suppliers or employees on Buyer's premises or any place where Buyer conducts
Page 6 of 11
operations, Seller shall take all necessary precautions to prevent the occurrence of any injury or
damage to persons or property during the progress of such work. Further, Seller shall indemnify,
defend and hold Buyer, Buyer's employees, and those for whom Buyer may act as agent harmless
for any injuries occurring to SeIler's agents, subcontractors, suppliers or employees and Seller
shall maintain public liability, property damage and employee's liability and compensation
insurance sufficient to protect Buyer from any claims under any applicable law, statute, or
regulation.
MODIFICATION; WAIVER. No waiver or modification of this order shall be effective unless
in writing and signed by both of the parties hereto. Failure of either party to enforce its rights
under this order shall not constitute a waiver of such rights or any other rights.
ENTIRE AGREEMENT. This order is intended by the parties as a final expression of their
agreement and also as a complete and exclusive statement of the terms thereof, any prior or
contemporaneous oral or written agreements as to the same subject matter notwithstanding.
. INVALIDITY. In the event that any provision of this order is declared invalid, illegal, or
otherwise unenforceable by any tribunal or law, the remainder of the provisions shall not be
affected thereby, and each term and provision not declared invalid, illegal or unenforceable shall
be valid and shall be enforced to the fullest extent permitted by law.
DRUG FREE WORKPLACE. By accepting this order,the Seller certifies that he shall provide a
drug free workplace for his employees in accordance with the laws of the State of Georgia.
SPECIFICATIONS, PROPOSALS, BID DOCUMENTS. The documents which form the basis
for this order shall include the plans and specifications and bid documents as attached hereto,
together with any other documents so listed and enumerated, if any, and it is expressly understood
that any special conditions listed and attached hereto are specifically made a part of this contract.
APPLICABLE LAW. The provisions and performance of this purchase order shall be governed
by the laws of the State of Georgia and applicable federal law. Seller agrees to bring any and all
actions relating to this purchase order only in the state and federal courts located within Chatham
County in the State of Georgia.
APPROPRIATION. Notwithstanding, any other provision hereof,this agreement shall terminate
at the end of each calendar year without liability or obligation on the part of the city in any
calendar year where the City has not appropriated funds for the obligations hereunder for the next
calendar year.
Page 7 of 11
1133- P00/.5 COIzS°h-uc -row/ /PC, .
ORIGIL Q UOTATION SHEET
A. Description:
$ ?, 895 `-
• Drain Pool Completely (by campground staff)
• Replace all grates (VGB), skimmers,jets and valves in pool
• Apply new fiberglass coating to entire pool shell, and decorative
coating(advise of options and styles)
• Remove all existing paint/stain, and apply new matching
decorative coating/with cool deck (advise of options) to include
repairing of any damaged concrete
• Remove all depth number tiles and replace with meters and feet
• Install "no diving" in tile on all four sides of pool on deck bull
nose coping (top)
• Replace existing 12v light system and replace with 120v system
• Grout all tiles in need of repair and preventatively.
• Install fixed ADA lift in compliance with all current and
applicable Federal ADA Regulations.
• Re-fill pool and check for any/all leaks, and repair as needed.
• Conduct pressure test to find, diagnose, and/or remedy any
leakage prior to completion
• All construction debris, and trash are to be addressed in areas
outside of pool fence on a daily basis. Trash and recycling
containers are located in close proximity to the pool, located
on either side of pool fence.
• Contractor will provide solid waste rollout dumpster for any
construction debris associated with project at predetermined
site, as defined by Campground staff.
�) DO
TOTAL COST: $
-r 4- o v
Quotation Expiration date: 1/3 / / a,9/3
Page 8 of 11
Woody Hemp[hm
From: chellexsp @gmail.com on behalf of MiChelle Payne [michelle @1 usagroup.com]
Sent: Thursday, January 03, 2013 4:18 PM
To: Woody Hemphill
Subject: Re: River's End Campground & RV Park Follow-up Items
Attachments: F-411RPL-AT1-SPEC-9-13-12.pdf; diamondbritebrochure.pdf
Attached is the spec sheets for the lift and the product brochure for Diamond Brite.
The optional upgrade price for Diamond Brite is $4,800.00.
Let me know if you need anything else.
I'm still waiting to hear from Sharon.
Thanks!
On Thu, Jan 3, 2013 at 3:51 PM, Woody Hemphill <whemnhill(c citvoftvbee.or r> wrote:
MiChelle,
Today is the deadline for the City Council agenda items. Outstanding items to be submitted include:
• Specs for the fixed lift to be installed to be submitted with the building permit application (this process can
take 7-10 days.)
• Revised price for the agenda item to go to Council next Thursday, January 10, 2013
Still waiting on these materials,
Woody Hemphill, Mgr.
River's End Campground & RV Park
5 Fort Avenue
PO Box 988
Tybee Island, GA 31328
whemohiil @citvoftvbee.ora
1
800.786]016:hdl-free
912.786.5518zffkce
912.786.4126ƒox
_��
...^.'.-..,..^.^.~......~^..-~.-.-..^.'.....^...�.^..�.~..-~....-..'.....^..~.^.,.-.-,.....~^..^.
This email and any files transmitted with it are con'Niential and intended soirdiy MI the use of the individual oi entity to whom they are addressed 1 you are not the
naniod addresseo you should not disseminate,distribute or cpv tha email Please:notify the s+^clm,immediately:ve,naux you have re.ce/ved this=mo//uv
mistake and delete this e-mail front ycur system.Please note Mat any AOWS Of opinions presented this email are solely these of the kithor and do not
necessarily represent those of The COy ofTybna 'the recipient should check this entaii and any attachments for tne,presence viruses,The City of Tybee
Island accepts no liability for any(tentage caiised by any virus transmitted by this emaii, City of Tybee island RO Bor.z74n7vuoa|u/ovu.".BA 31323
.�..~�.°.^.~.~..~-^......-...~.^.....^.-~,.-^.'.~....~.^^.~.~`..'..~.~-...~........,....-.-.~
Sincerely,
MiChelle E. Payne
670-697-4925
nnxn*.lnSaar0np corn
Form W`9 Request for Taxpayer Give fora, to the
(Rev.October 2004) Identification Number and Certification requester. Do not
Department of the Treasury send to the IRS.
Internal Revenue Service
c.4 I Name(as re, ocl on your come return)
o- Business name,if different from above
g
a_i Individual/ i—� �-7
4% is Check appropriate box: r--1 Sole proprietor Corporation i l Partnership 1 i Other ► 1-1 withholding
backup
o E Requester's name and address(optional)
rn Address(nu er street an apt.w s )
C CI\€r Lue-11 ()1/ O )75
A 1I list account nnber(s)hare(optional)
jJ Taxpayer Identification Number (TIN)
Enter your TIN in the appropriate box.The TIN provided must match the name given on Line 1 to avoid Social security number
backup withholding. For individuals.this is your social security number(SSN). However,for a resident 1 I 4 1 4 1 1 1
alien,sole proprietor, or disregarded entity,see the Part I instructions on page 3. For other entities, it is
your employer identification number(EIN). If you do not have a number, see How to get a TIN on page 3. or
Note.If the account is in more than one name, see the chart on page 4 for guidelines on whose number Employer identification,number
to enter. 171 O4 I6 I 16 131
Part II Certification
Under penalties of perjury, I certify that:
1. The number shown on this form is my correct taxpayer identification number(or I am waiting for a number to be issued to me),and
2. I am not subject to backup withholding because: (a) I am exempt from backup withholding.or(b) I have not been notified by the Internal
Revenue Service(IRS)that I am subject to backup withholding as a result of a failure to report all interest or dividends,or(c)the IRS has
notified me that I am no longer subject to backup withholding. and
3. I am a U.S.person(including a U.S. resident alien).
Certification instnactions.You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup
withholding because you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply.
For mortgage interest paid, acquisition or abandonment of secured property,cancellation of debt, contributions to an individual retirement
arrangement(IRA).and generally. yments other than interest and dividends,you are not required to sign the Certification, but you must
provide your correct TIN./See t stpaCtion�n 9.) y
e uU 3 p ts on► // ' // / Date P. / //9///<..
2 Here I v y / /
- -
• City of Tybee Island, PO Box 2749, Tybee Island, GA 31328
912-786-4573 I (fax) 912-786-9465
What products/services do you provide to the City of Tybee Island:
slur/k of 1 pI l 6!),6-if-ced,L,,,,,_ i igo
To whom shall we direct the Purchase Order?
Sales Contact: / I/ //e_ P /1 Email: M/d A Pi 1,54/1/1-7-//0 ed/'it,
Phone# W-77-c7`?' I ! 2- Fax# g71-)— (94/1 087::
Location: 56 kiC,Ud c-k e_ 4-i)-13„).., E // (_.W. :3W,5
To whom shall we direct Payment?
A/R Contact:1� _C t Leqq Email:(),ei0i0i0 Gtr Pis • eon
/ vim
Phone#/O7s-'X52 -.6 , Fax# 277-2 dZ - 0872
Remittance Address: P12/7Q as C
Our terms are Net 30.
Page 9 of 11
` Verifying Status
for City Public Benefit Application
By executing this affidavit under oath, as an applicant for a City of Tybee Island, Georgia, Business License or Occupation Tax
Certificate,Alcohol License,Taxi Permit,Contract,or other public benefit as referenced in O.C.G.A.Section 50-36-1,I am stating the
following with respect to my application of a City of Tybee Island:
• Business License or Occupational Tax Certificate,
• Alcohol License,
(circle all that apply)
• Taxi Permit,
• Contract
• Other public benefit
for _ (printed name of natural person applying on behalf of
individual,business, corporation,partnership,or other private entity).
1) X I am a United States citizen.
2) I am a legal permanent resident 18 years of age or older or I am an otherwise qualified alien or non-immigrant under
the Federal Immigration and Nationality Act, 18 years of age or older and lawfully present in the United States. *
In making the above representation under oath,I understand that any person who knowingly and willfully makes a false, fictitious,or
fraudulent statement or representation in an affidavit shall be guilty of a violation of Code Sec on 16-10-20 of the Official Code of
Georgia.
Signature of Applicant" f
01/02/2013
Date
MiChelle E. Payne
Printed Name
*Alien Registration Number for Non-citizens r
SUBSCRIBED AND SWO RE ME ON THIS
THE ` DAY OF -,F ,20 1—e�
.
Notary Public
My Commission Expires: \ '\ 4 \
Note: O.C.G.A. §50-36-1(e)(2) requires that aliens under the federal Immigration and Nationality Act, Title 8 U.S.C., as amended,
provide their alien registration number. Because legal permanent residents are included in the federal definition of-alien", legal
permanent residents must also provide their alien registration number. Qualified aliens that do not have an alien registration number
may supply another identifying number below:
•
CONTRACTOIs AFFIDAVIT AND AGREEMENT
By executing this affidavit, the undersigned contractor verifies its compliance with O.C.G.A 13-10-91, stating
affirmatively that the individual, firm, or corporation which is contracting with (State Recipient/Sub-recipient),
under the Community HOME Investment Program (CHIP), has registered with and is participating in a federal work
authorization program* [any of the electronic verification of work authorization programs operated by the United
States Department of Homeland Security or any equivalent federal work authorization program operated by the
Department of Homeland Security to verify information of newly hired employees, pursuant to the Immigration
Reform and Control Act of 1986 (IRCA), P.L. 99-603], in accordance with the applicability provisions and deadlines
established in O.C.G.A 13-10-91.
The undersigned further agrees that, should it employ or contract with any subcontractor(s) in connection with the
physical performance of services pursuant to this CHIP-funded contract with (State Recipient/Sub-recipient),
contractor will secure from such subcontractor(s) similar verification of compliance with O.C.G. A. 13-10-91 on
Subcontractor Affidavit provided in Rule 300-10-01-.08 or a substantially similar form. Contractor further agrees to
maintain records of such compliance and provide a copy of each such verification to the (State Recipient/Sub-
recipient) at time the subcontractor(s) is retained to perform such service.
_fEa in sal-0(9/ (EVr37
Federal Work Authorization User Ide ification Number
3//69 /
Date of Aut orization
R i / r1/4
Authorized Officer or Agent of- ontractor Pool
2. 4e�S :�ic1/ eafi @Ad
Name of Proje t
Li 4-1A .9 I 4)0420 14114d
Name-of Public Employer
I hereby declare under penalty of perjury that the foregoing is true and correct.
Executed on , / 9 20 /3 in &7 /0e/( (city) 2 (state)
//,Al
Signature of Authorized Office Agent
)22 i Neh- L-- . 4 ne■ i iLa-(If/t1 /2/4/4 /7
Printed Name of Authorized Officer`ef Agent
SUBSCRIBED AND SWORN
BEFORE ME ON THIS THE l,,��
/G/ DAY OF Der 2, 01 .
/
a s _//X Notary Public: % \ 17-11"11 % .
My Commission Expires: \ ---)\I �_')II Z 15`
Page 11 of 11
r>4."1714917-,51%1`.: ?-'9,t;fot;roox-,?,7r111 .111t.:- .70"Prowt-.‘frk,..1.40: 71:411.14011T1`1.16t.1.!M-tostirt- .1.11 .1,ZA,. .„
, ..
-.. -
- .
1 OCCUPATION TX CERTIFiCATIE
City Of Roswell
BUSINESS REGISTRATION OFFICE
38 Hill Street, Suite G-30
Roswell GA 30075
Phone: 770/641-3780
....,..
■ ,....:A
•'t-A
-..■
.,.1
a.;
,... .
•I
Mailing Address
USA Pools,LIc
:
Roswell GA 30075-3608 Business Location
1073 GREEN ST
1073 Gr,en Street i)--; y
R \ r[.[ ( \. . .
,
::,F A
: • ','S
. i
V9.1...i.... ,{6.! 11.4 4 il 4)
:i •...,,,,
``...;• :i
I
'`.•.‘.:'
•:..;,j
Expiration Date:
12/31/2012 SERVICE Description: Tax Year:
2012
r•-.-.•:•
t--:-
-..*. 1
This certificate shall be displayed in a conspicuous place in your business establishment and is not
-- ,, transferable to any other location,business or owner without proper notilication to the City of Roswell. ;;....4
i.:„.:.:-:..",:-:.1.40,:-.:,::::,,;.44....:.;::: :.i ja4,-.7.,:i,...;it.:.::.,..:0.z;i.i.•,,,i-gti...,. i.L...ij.:.7..., ..:...:... :,:......, .-..:,:.:.J„.: .i.,i-i,....i.1.0:;a4...;4:1;;4.;,;...:::r,i;:.,..:7,,:;.::::7,,,:.:7,,:i...:.::....,.....:.......... ...:..-..,1_, .....,;....,53
-GENERAL\IN_ToCm,it:N.Clerk
CTEY OF�TBYtBEE ISLAND P RC Z! F Ave
Tybee is aOnd,eGA31328-2749 PO Number: 13 m 21 / 7 0
Ph(912)786-4573 FAX(912)786-5832 This number must appear on all related
correspondence,shipping papers and invoices.
vendor # : 01-007927 Data: 01/23/2013 Requisition # : 13-21770
tO: USA POOLS CONSTRUCTION, INC . Ship to: CITY HALL
885 WOODSTCOK RD . 403 BUTLER AVENUE
STE 430-132 TYBEE ISLAND, GA 31328
ROSWELL, GA 30075
F.O.B. Point -Tybee Island, GA Terms - Net 30 days
LINE UNITS DESCRIPTION PRICE AMOUNT
1 0.00 1st Installment 100-6180-54-1100 0.00 21, 347.50
Half of contract amount- per payment schedule.
Purchase Order void after 90 days.
Special Instructions: TOTAL 21, 347 .50
Authorized by Date
For the City of Tybee Island
agree to provde the items/services listed on this
purchase order and accept the Purchase Order
Terms and Conditions that accompany this form.
Supplier Acknowledgement Date
Form W.9 .
.
Request for Tr,sxpayer Give form to the
ilaay.October 2004) Identification Number and Certification 1 requestP■r. Do not
Cvvpartn-svnt of th4 Treeoury ■ send to the CRS.
IntArned Rvonanue 84.rvic*
- .
clNOT:,(318 re...mted on your jgcome'Lys.return) i .
) tisp- pa:51-5 cop&-ruckent , Inc,
c■-• Business name,if different from above
c
0
..g r—i Individual/ 1---1 Exempt from backup
Q Check appropriate box' 1_1 Sole proprietor Corporation El Partnership El Other 11. L_J withholding
8 E
..„ 7, Address inurrdi;j2,or strt an. il apt.lor stile Ir) sic Requester's name and address(optional)
E. -8-?5
ca. ,,, . (-• A4S1-&-g- K-001 , ' 4-‹-n0-11 S ;--
7.--
CI tS state.and ZIP code
I1.5
er
.. Rmotli ( 4 30075
cs List account numbers)here(optional)
e)
C;)
Part I Taxpayer Identification Number (TIN)
Enter your TIN in the appropriate box.The TIN provided must match the name given on Line 1 to avoid social security number
backup withholding. For individuals,this is your social security number(SSN). However,for a resident I I -I- I 4 I I
alien, sole proprietor, or disregarded entity.see the Part 1 instructions on page 3. For other entities,, it is
your employer identification number(EN). If you do not have a number, see How to get a TIN on page 3. or
Note.If the account is in more than one name, see the chart on page 4 for guidelines on whose number Employ0.er identification number
to enter. ', 11-01514V :016
Part II II Certification
Under penalties of perjury, I certify that
1. The number shown on this form is my correct taxpayer identification number(or I am waiting for a number to be issued to me).and
2. I am not subject to backup withholding because: (a) I am exempt from backup withholding.or(b) I have not been notified by the Internal
Revenue Service(IRS)that I am subject to backup withholding as a result of a failure to report all interest or dividends. or(c)the IRS has
notified me that I am no longer subject to backup withholding. and
3. I am a U.S.person(including a U.S. resident alien).
Certification instructions.You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup
withholding because you have failed to report all interest and dividends on your tax return. For real estate transactions. item 2 does not apply.
For mortgage interest paid,acquisition or abandonment of secured property.cancellation of debt, contributions to an individual retirement
arrangement(IRA), and generalty, yments other than interest and dividends,you are not required to sign the Certification, but you must
provide your correct TIN./See diap
ee instpx7tioon91.)ya,ef
i /
Sign Signature of
4/ ./41....#0.. ' _____
Here U.S.person 10.Z ' _ - Date ■ / /1/49/7/<,
, / i
..... .. _
City of Tybee Island, PO Box 2749, Tybee Island, GA 31328
912-786-4573 I (fax) 9112-786-9465
What products/services do you provide to the City of Tybee Island:
, .
. ,
'7(1
SOfrititiil Pa ' il
' siat4i ›k__ /inoti2-4zm,__
---). 1 To whom shall we direct the Purchase Order?
, . .
i . ii
Sales Contact:/2? aetnLymaii: Intel/1,1k!PI_Ii.54 -71--tii
Li
Phone# ?77-,VEN.- /77 2.- Fax# q7ri''e .,94 -0T7,2-
, jr, , 1 i
Location: S16 /4Joie;d4-a_k Pei i Sig._ 2-/----i)—/a; i6,-. 0,./2,11 (,), 4 75
To whom shall we direct Payment?
A/! Contact:b2196 i4qci 4 joiO i
Email:t_,ek- A.5a_Podoof - eeom
/ .
phone#(07k- 5 -3-6 b Fax#<2 77 --,2-. 4 -08?2-
Remittance Address: Sililf2- ass
Our terms terms are Net 30.
Page 9 of 11
Aftlfzvfit VenifvIlnIlg Status
for City Pi.a ba Ie efft Appinentfl®nn
By executing this affidavit under oath, as an applicant for a City of Tybee Island, Georgia, Business License or Occupation Tax
Certificate,Alcohol License,Taxi Permit,Contract,or other public benefit as referenced in O.C.G.A. Section 50-36-1,I am stating the
following with respect to my application of a City of Tybee Island:
r
Business License or Occupational Tax Certificate,
• Alcohol License,
(circle all that apply)
• Taxi Permit,
• Contract
• �Otther public ben it
for rn{`� �.1 (e_ E ao (printed name of natural person applying on behalf of
individual, business, corporation,pcnership, or other private entity).
^
1) I am a United States citizen.
OR
2) I an a legal permanent resident 18 years of age or older or I am an otherwise qualified alien or non-immigrant under
the Federal Immigration and Nationality Act, 18 years of age or older and lawfully present in the United States. *
In making the above representation under oath,I understand that any person who knowingly and willfully makes a false, fictitious, or
fraudulent statement or representation in an affidavit shall be guilty of a violation of Code Section 16-10-20 of the Official Code of
Georgia.
/ 7:/' y /"-dliP
Signature of A licant
/ 792
Date
/27/71,hdi-e- i'---;- g 61 f)e,
Printed Name v
* Alien Registration Number for Non-citizens
SUBSCRIBED AND S ORN BEFORE-M`r THIS
THE /1 DAY OF , , 1 / �—
Notary Public / i' 19 I '�
My Commission Expiks: - Y I k .,-_-
Note: O.C.G.A. §50-36-1(e)(2) requires thcp aliens under the federal Immigration and Nationality Act, Title 8 U.S.C., as amended,
provide their alien registration number. Because legal permanent residents are included in the federal definition of"alien", legal
permanent residents must also provide their alien registration number. Qualified aliens that do not have an alien registration number
may supply another identing number below:
Page 10 of 11
CONTRACTOR AFFIDAVIT AND AGREEMENT
By executing this affidavit, the undersigned contractor verifies its compliance with O.C.G.A 13-10-91, stating
affirmatively that the individual, firm, or corporation which is contracting with (State Recipient/Sub-recipient).
under the Community HOME Investment Program(CHIP), has registered with and is participating in a federal work
authorization program* [any of the electronic verification of work authorization programs operated by the United
States Department of Homeland Security or any equivalent federal work authorization program operated by the
Department of Homeland Security to verify information of newly hired employees, pursuant to the Immigration
Reform and Control Act of 1986 (IRCA), P.L. 99-603], in accordance with the applicability provisions and deadlines
established in O.C.G.A 13-10-91.
The undersigned further agrees that, should it employ or contract with any subcontractor(s) in connection with the
physical performance of services pursuant to this CHIP-funded contract with (State Recipient/Sub-recipient),
contractor will secure from such subcontractor(s) similar verification of compliance with O.C.G. A. 13-10-91 on
Subcontractor Affidavit provided in Rule 300-10-01-.08 or a substantially similar form. Contractor further agrees to
maintain records of such compliance and provide a copy of each such verification to the (State Recipient/Sub-
recipient) at time the subcontractor(s) is retained to perform such service.
(E / r )-- 3=5_ 16W-8-‘11-- I()i Sal-- 0/9-, ( - '4,01-) )
Federal Work Authorization User Ide 'fication Number
3//&' 7
Date of Authorization i
5aArili
Authorized Officer or Agent ofagontractor j
P �0 P'L_ , 2', vus 6( ear 4
Name of Pro'e t
i / D Yee- ti
NameePublic Empll4yer
I hereby declare under penalty of perjury that the foregoing is true and corr ect.
C
Executed on d / % 20 4,3 in RO3Ce (city) C4 (state)
, / .
i
% / i%-7-z----,/
Si nature of Authorized Offide Agent
01(7.filie.11 _ 2.-- _ _ a4pe, i 4.6024-1- A/w(r<(7
Printed Name of Authorized Officers Agent
SUBSCRIBED AND SWORN
BEFORE ME ON THIS THE
1 DAY OFgmbe , 0�
,x.Notary Public: / IZ 1°t t e-
My Commission Expires: ���
Page 11 of 11
•ec 21 2022 3e35PM River 's End
j
f l Campground 9127864126 page 1
5A- 'Cc"�isp(.<rh-LldiO , Jac..
ORiGINAL
A. De @crisp on:
$37, 855
• Drain Pool Completely(by campground staff)
• Replace all +ates (VGB), skimmers,jets and valves in pool
a Apply new fiberglass coating to entire pool shell, and decorative
coating(advise of options and styles)
• Remove all existing paint/stain, and apply new matching'
decorative coating/with cool deck(advise of options)to include
repairing of any darnaged concrete
o Remove all depth number tiles and replace with meters and feet
o Install "no diving"in tile on all four sides of pool on deck bull
nose coping(top)
o Replace existing 12v light system and replace with 120v system
o Grout all tiles in need of repair and preventatively.
o install fixed ADA lift in compliance with all current and
// applicable Federal ADA Regulations.
• Re-fill pool and check for any/all leaks, and repair as needed.
▪ Conduct pressure test to find, diagnose, and/or remedy any
leakage prior to completion
�e/ a API aonstructlou cleibrris, and trash are to be addressed in 2r3
outside *ff pod fence on a daily basis. TrasIn and recycling
containers are located in close proximity to the pool,iloczted
/ on either side of pool fence.
a Contractor will provide solid waste rollout dumpster for any
construction debts associated with project at predetermined
site, A s deffrced b cC1ampgroanrridi staff.
dO7A7. COST: S S1, F956.
Quotation Expiration date: /3 i / c90,3
Page 8ofr11